Association between skull bone mineral density and periodontitis: Using the National Health and Nutrition Examination Survey (2011–2014)

Abstract

Background and objective Bone mineral density (BMD) and periodontitis have been the subject of many studies. However, the relationship between skull (including mandible) BMD and periodontitis has not been extensively studied. An objective of this cross-sectional study was to examine the relationship between skull BMD and periodontitis using data from the National Health and Nutrition Examination Surveys (NHANES) for 2011–2012 and 2013–2014. Materials and methods From NHANES 2011–2014, 3802 participants aged 30–59 were selected. We divided the skull BMD level into quartiles to check the distribution of variables. Periodontitis was defined by the Centers for Disease Control and Prevention (CDC) and the American Association of Periodontology (AAP) in 2012. Multivariate logical regression analysis was used to explore the independent relationship between skull BMD and periodontitis. The generalized additive model (GAM), smooth curve fitting (penalty spline) and threshold effect analysis was used to evaluate dose-response relationship between skull BMD and periodontitis and the potential nonlinear relationship between skull BMD and periodontitis. Finally, subgroup analysis and interaction test were conducted to determine the role of covariates between skull BMD and periodontitis. Results The overall average skull BMD of 3802 participants was 2.24g/cm2, the average age was 43.94 years, and the prevalence of periodontitis was 41.03%. In the fully adjusted logistic regression model, skull BMD and periodontitis showed an independent negative correlation (OR 0.73, 95% CI 0.59–0.90, P = 0.0032) and a linear relationship. Compared with the lowest quartile array (Q1:1.22–1.98) of skull BMD, the highest quartile array(Q4: 2.47–3.79) had a significantly lower risk of periodontitis (OR 0.70,95% CI 0.56–0.87, P = 0.0014). Subgroup analysis showed a highly consistent negative correlation between skull BMD and periodontitis. In the interaction test, people with moderate poverty income ratio (1.57–3.62) and those who had more than 12 alcohol drinks in the past year had a lower risk of periodontitis. Conclusions This result suggested that periodontal disease can be related to low skull BMD, for those people, oral hygiene and health care should be more closely monitored. Validation of our findings will require further research.

The association between oxidative balance score and periodontitis in adults: a population-based study

“…In the fully adjusted model, participants in the highest quartile had a 29% lower risk of periodontitis compared to those in the lowest quartile of OBS [0.71 (0.42, 0.98)]. Supplementary Tables 2, 3 demonstrate the association between OBS and periodontitis-related variables, with results showing that higher OBS scores are associated with lower C-reactive protein levels and with higher grades of self-reported oral health. Mean ± SD for continuous variables: the P-value was calculated by the weighted linear regression model.…”

“…Periodontitis is a common inflammatory disease of the oral cavity (1, 2), with the majority of cases occurring in people aged 55-59 years old (3), which is an important cause of tooth loss in adults (4). Plaque biofilm initiates the process, influencing the host's immunological function and inflammatory response (5,6).…”